An adherence monitoring system in antiretroviral therapy

Abstract

This study investigated the use of a Multi-dimensional system to improve adherence monitoring in antiretroviral therapy (ART). The high adherence levels required during patient therapy and the consequences of adherence failures (virus mutation to drug resistant strains, treatment failure, fatality) necessitated this study, with the hope that the development of a system would provide a basis for deployment of similar systems in other ART providing centers. An ART providing health centre (Mbuya reach out) was selected as a case study, with data collected from the centre used as a basis for the system design, development, testing and validation. Data was gathered through interviews, content analysis and direct observation; the rational unified process (RUP) of system development was then used to develop the system. Unified modeling Language (UML) was used to document the system development process, producing artifacts such as use case models, domain models, collaboration diagrams and System sequence diagrams. The final system was entirely implemented in open source (MySQL and PHP) and hosted to an online web server with the findings revealing that adherence monitoring can indeed be improved by using the system, but there is still need for further research in protecting the data and the tweaking of the system to enable monitoring not only for adults but for children as well. It is recommended that leading ART providing centers in conjunction with Ministry of health champion the use of the system by training users to exploit the functionality of the system, and encourage use of the system with a goal of developing a comprehensive information base for future studies on adherence.